title: Comparison of aliskiren/hydrochlorothiazide combination therapy with hydrochlorothiazide monotherapy in older patients with stage 2 systolic hypertension: results of the ACTION study.
abstract: Patients with stage 2 systolic hypertension require sizable blood pressure (BP) reductions to achieve recommended targets. This randomized double-blind study compared a single-pill combination of the direct renin inhibitor aliskiren and hydrochlorothiazide (aliskiren/HCTZ) with HCTZ monotherapy in older patients (older than 55 years) with systolic BP ≥160 mm Hg and <200 mm Hg. After a 1- to 4-week washout, 451 patients were randomized to once-daily aliskiren/HCTZ 150/12.5 mg or HCTZ 12.5 mg for 1 week, and then double the doses for 7 weeks. Overall baseline BP was 168.8/91.4 mm Hg. At week 4 (primary) end point, aliskiren/HCTZ provided significantly greater BP reductions from baseline than HCTZ monotherapy (29.6/9.3 mm Hg vs 22.3/6.8 mm Hg) and resulted in a greater proportion of patients achieving BP goal of <140/90 mm Hg (51.1% vs 33.3%). Aliskiren/HCTZ therapy provides substantial BP reductions and may thus be a useful treatment option for older patients with stage 2 hypertension.
authors.affiliation: Ralph H Johnson VA Medical Center and Medical University of South Carolina, Charleston, SC 29401, USA. basilejn@musc.edu
authors.forename: Jan
authors.initials: J
authors.lastname: Basile
authors.forename: Simon
authors.initials: S
authors.lastname: Babazadeh
authors.forename: Michael
authors.initials: M
authors.lastname: Lillestol
authors.forename: Jaco
authors.initials: J
authors.lastname: Botha
authors.forename: Carol
authors.initials: C
authors.lastname: Yurkovic
authors.forename: Richard
authors.initials: R
authors.lastname: Weitzman
mesh_terms: D000367:Age Factors; D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006305:Health Status Indicators; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013599:Systole; D016896:Treatment Outcome; D014481:United States
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D004232:Diuretics; D005650:Fumarates; D006852:Hydrochlorothiazide; C446481:aliskiren